|
|
|
FIRST* |
|
|
| LAST* |
|
|
ADDRESS:* |
|
|
CITY:* |
|
|
| STATE: |
|
|
| ZIP:* |
|
|
PHONE / EMAIL: |
|
HOME: |
|
|
WORK: |
|
|
| EMAIL:* |
|
|
How Did You hear about us?
|
|
PHILADELPHIA INQUIRER
PHILADELPHIA STYLE MAGAZINE
PHILADELPHIA MAGAZINE
SIGNAGE
BILLBOARD
DRIVE-BY
WEBSITE
BROKER
RADIO STATION |
|
| Other: |
|
|
| ARE YOU WORKING WITH A BROKER?* |
|
|
|
|
| If Yes, what is their name? |
|
|
| DO YOU PRESENTLY: |
|
OWN A SINGLE FAMILY HOME
OWN A CONDOMINIUM TOWNHOUSE
RENT |
|
| Other: |
|
|
| Housing Size Preference: |
|
|
|
|
| AGE OF HEAD OF HOUSEHOLD: |
|
|
|
|
| FAMILY STATUS: |
|
|
|
|
| WHAT I EXPECT TO PAY FOR MY HOME: |
|
|
|
|
| Reason for purchase: |
|
|
|
|
|
|
|
|
|